Laparoscopic or similar surgeries where a tube with a light and a camera lens at the end (laparoscope) is employed to examine organs, check for abnormalities, or perform minimally invasive surgeries are a desirable alternative to prior surgical techniques requiring large incisions. In a similar fashion, procedures in gastroenterology employ such devices to search for and remove colorectal polyps which form on the lining of the intestine.
Such procedures generally employ a small camera adjacent to the instruments inserted through small incisions in the patient's body, or into cavities of the patient's body. Such procedures may involve removal of tissue for a specific ailment, such as the gall bladder, or may be exploratory in nature where tissue samples are taken and removed from the body for examination and testing. Just a few such operations include but are not limited to, a polypectomy, a bronchoscopy, a bulboscopy, a colonoscopy, a duodenoscopy, an endoscopy and a gastroscopy. Rather than a catheter type device, when used for low invasive procedures through the lower intestine such devices are also specialized as for Endoscopy or in many other specialized versions including but not limited to a gastroscope, or colonoscope, or sigmoidiscope or bronchoscope. These types of devices generally have the video component following a collinear path in a common flexible conduit.
Manually operable surgical devices employed for such procedures inside a patient's body by a surgeon from a position outside the patient are widespread and well known. In a conventional procedure, the cutting and retrieval components employed by the surgeon are located at the distal end of the surgical instrument. In a conventional polyp removal procedure, an endoscope is inserted into an internal cavity of a patient, and manipulated to search for any abnormal tissue growths such as polyps. If tissue such as a polyp is located for removal, a wire extending through an elongated pathway in the biopsy channel of the endoscope is translated toward the distal end of the device to project a cauterization loop connected to the wire from the distal end of the pathway running through the endoscope. Using a video display, the surgeon then manipulates the loop and the endoscope from outside of the patient and engages the loop with the polyp. The wire is positioned around the base of the polyp whereafter an electrical current is communicated to the loop to cut and cauterize the region.
As can be ascertained, in such a procedure, where tissue is removed for sampling or as an object of the procedure, it is imperative that the surgeon is able to view the tissue in question at the distal end of the surgical device deployed into the patient. Viewing is conventionally achieved over a fiberoptic link from a lens to a video display viewed by the surgeons outside the body of the patient.
Avoiding interference with the view of the surgeon, is particularly important when small tissue samples are being removed such as a polypectomy because the polyps being removed are small and easily missed. Further, once removed, they must be located and retrieved with a retrieval component.
Unfortunately, conventional capturing devices for this purpose, are formed as nets or netting in a fine mesh. The mesh, especially in the small confines of body cavities such as the intestine, can severely impair the view by blocking it from camera view. Further, the interconnecting mesh of such devices communicates electrically or offers the potential for such, and they are inhibited from functioning as both the snare or tissue removal instrument as well as the catch basket in combination. Other wire formed baskets employed for the purpose impart the same visual impairments as mesh type capture devices.
As such, using conventional mesh net style retrieval components, or wire-formed capture components, subsequent to locating and removing a polyp or other tissue portion by the electrified cauterization component, is a difficult task due to the impairment of the view of the internal cavity. Additionally, most such net style or wire formed retrieving components, are not easily positionable around the tissue, or around a lost surgical device, because the netting which is engaged around the mouth of the net, impairs or prevents positioning and rotation of the mouth in the small confines of an intestine or other small body cavity.
The device and method herein disclosed and described features a cutting or cauterizing component to which a radially deployable capturing component is initially engaged in a retracted position. The capturing component is formed of radially oriented members extending from mouth portion which forms the cutting or cauterizing component. The shape of the members is infinite as is the number and positioning thereof. The members can thus collapse to form virtually any shape planar component such as an oval, a crescent, a hexagon, or any other
geometric shape to which the radially deployable members or members can be formed.
The radial deployment is also infinitely variable in both the number of deployable members or wires, and their deployment around the axis formed by the distal end of the wire engaging them. Thus the capture component can be deployed radially around the axis from a full 360 degrees down to a minimum required to form a capture component such as 100 degrees or more preferably 180 degrees of radial deployment.
Unlike most netting or mesh basket collection components, or other wire or member-formed capture components, the radially oriented wires forming the capture component or catch basket of the device herein disclosed, in the retracted position, are rotated from their relative positions around the axis to adjacent positions abutting each other. This forms a generally planar snare or elongated member which operates as the cauterizing or cutting component while the device is retracted.
Of course the device can also be employed simply as a deployable capture component without the cauterizing or cutting loop and still be a great improvement to the art. With the plurality of wires or elongated members forming loops in virtually any geometric shape, the device, as a capture component, can be deployed in the collapsed position with the radially deployable loops restrained adjacent to each other to form a generally planar loop member. Once properly positioned, the means for restraint can be released wherein the loops will deploy radially around the axis extending from the control wire they engage. As noted the formed capture component can be of any shape to which the members forming the loops are shaped and can be in any number and at any radial deployment as suits the purpose all the way to a 360 degree deployment of spaced members.
When employed with a cauterizing or cutting members, during the initial cutting procedure, the radially deployable members forming the basket, are compacted and engaged to a formed mouth portion, out of view of any video cameras. This retractable position markedly increases the field of view for the surgeon trying to cut or cauterize tissue.
Also noted, there is employed a restraint device to maintain the radially deployable members or wires forming the basket or capture component in the collapsed position. This restraint device may be a heat released restraint which will automatically deploy the members radially to form the capture component when the aperture heats to cut or cauterize. Or, the restraint device may be mechanical in nature where a force or a wire operated release component is employed to release the members from their constrained position out of view to expand radially around the axis to the degree desired. Other releasable means for restraint of the radially deployable members can be employed such as hook and loop fabric, tape, or any means for releasable restraint as would occur to those skilled in the art.
Consequently, a surgeon viewing the intended target using the camera with the radially deployable members constrained by the restraint device, has an uninterrupted view of the tissue to be removed or retrieved for a much improved view for the surgeon on the viewing screen outside the body of the patient. The surgeon can thus easily see even the smallest tissue to be retrieved and rotate or manipulate the mouth of the radially formed catch basket over it. Once finished, the members forming the capture component such as a basket are deployed from the loop forming the aperture or the mouth to which they are radially abutted by the restraint device during the cutting or cauterizing procedure.
The members forming the loops of the capture component will best be biased to deploy to the radially deployed position spaced from each other and at positions around the center axis to form the capture component. This can be done during initial forming using shaped memory material which will return to its original position around the center axis or other means for biasing the members to a radial deployment at any spaced angular deployment around the axis.
All embodiments of the device enjoy this additional utility provided by their radially oriented wire formation of the capture component or basket from this restrained position to the released position. As noted, an infinite number of geometric shapes may be employed for the radially deployable members or loops and when retracted, the shape of the mouth or aperture of the capture component is substantially similar to that of the deployable loop members.
In this respect, before explaining at least one embodiment of the invention in detail, it is to be understood that the invention is not limited in its application to the details of construction and to the arrangement of the components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments and of being practiced and carried out in various ways. Also, it is to be understood that the phraseology and terminology employed herein are for the purpose of description and should not be regarded as limiting.
As such, those skilled in the art will appreciate that the pioneering conception of a radially expandable biased capture component upon which this disclosure is based, may readily be utilized as a basis for designing other methods and systems for carrying out the several purposes of the present invention of a tissue retrieval system for surgery. It is important, therefore, that the claims be regarded as including such equivalent construction insofar as they do not depart from the spirit and scope of the present invention.
An object of this invention is the provision of a cutting and cauterizing loop to which an underlying basket or capture component is retractable and held by a heated or mechanically releasable restraint, thereby enhancing the view of the tissue during the cutting or cauterizing procedure.
An additional object of this invention is the provision of such a retrieval or capture component which is formed from radially deployable members having gaps therebetween which is deployable from a retracted substantially planar position by releasing a restraint which may be heat released, mechanically released, or otherwise released.
Another object of this invention is the formation of a radially deployable capture component formed in virtually any geometric shape which may be employed singularly or in combination with a cauterization loop.
An additional object of this invention is the formation of a capture component by deployment of biased radially deployable members to spaced positions anywhere around an axis.
These together with other objects and advantages which will become subsequently apparent reside in the details of the construction and operation as more fully hereinafter described and claimed, reference being had to the accompanying drawings forming a part thereof, wherein like numerals refer to like parts throughout.